The Iowa Guide to the Ophthalmology Match - Jesse Vislisel, MD University of Iowa Updated July 2015
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The Iowa Guide to the
Ophthalmology Match
Jesse Vislisel, MD
University of Iowa
Updated July 2015
Contents
Overview.......................................................................................................................................... 3
First and Second Year ...................................................................................................................... 4
Preclinical Course Grades ............................................................................................................ 4
Extracurricular Activities ............................................................................................................. 4
USMLE Step 1 Board Exam .......................................................................................................... 4
Third Year ........................................................................................................................................ 5
Clinical Grades ............................................................................................................................. 5
Letters of Recommendation ........................................................................................................ 6
Curriculum Vitae .......................................................................................................................... 6
Faculty Meeting ........................................................................................................................... 7
Eye Rounds .................................................................................................................................. 7
Fourth Year ...................................................................................................................................... 7
Electives ....................................................................................................................................... 7
Away Rotations ............................................................................................................................ 8
USMLE Step 2 Board Exams ......................................................................................................... 8
Alpha Omega Alpha (AOA) .......................................................................................................... 9
Time Off ....................................................................................................................................... 9
The Application Process ................................................................................................................ 10
Residency Overview .................................................................................................................. 10
Acronyms ................................................................................................................................... 10
Electronic Application ................................................................................................................ 11
Personal Statement ................................................................................................................... 12
Program List ............................................................................................................................... 13
Supporting (Mail Submission) Materials ................................................................................... 13
Letters of recommendation ................................................................................................... 14
Transcripts ............................................................................................................................. 14
USMLE Board Scores .............................................................................................................. 14
AOA Induction Letter ............................................................................................................. 15
1|PageAdditional Materials .............................................................................................................. 15
Submission ............................................................................................................................. 15
Dean’s Letter ............................................................................................................................. 15
Choosing Ophthalmology Programs .......................................................................................... 16
Choosing Programs for Intern Year ........................................................................................... 19
Interviews ...................................................................................................................................... 20
Master Calendar ........................................................................................................................ 20
Smartphones ............................................................................................................................. 21
Interview Number ..................................................................................................................... 22
Dinners and Socials .................................................................................................................... 24
The Interviews ........................................................................................................................... 24
Thank You Notes........................................................................................................................ 27
Travel ............................................................................................................................................. 27
Planes ........................................................................................................................................ 28
Cars ............................................................................................................................................ 29
Trains ......................................................................................................................................... 30
Hotels......................................................................................................................................... 30
The Rank List .................................................................................................................................. 31
The Match Algorithm................................................................................................................. 31
The Match...................................................................................................................................... 33
Useful Links .................................................................................................................................... 34
2|PageOverview
Ophthalmology is an incredibly fascinating and rewarding field. It offers a distinctive
combination of medical and surgical management while utilizing amazing technological
devices to maintain and restore vision. Because many consider vision the most prized of
the senses, ophthalmologists can make a tremendous impact on the lives of their
patients. The ophthalmology application and match process is fairly unique, in that it is
coordinated by the San Francisco Matching Program rather than the Electronic
Residency Application Service (ERAS) like most other specialties. As a result, the field
has its own Match Day and application deadlines. It is a huge relief to match months
before your peers, but having a separate application process can make the process
extremely confusing. Unfortunately, there is no consolidated source of information for
the ophthalmology match. While preparing my own application, I gathered information
from peers, residents, faculty, websites, and books. This guide attempts to consolidate
the most important of this information in hopes that it will make your life easier during
your preparation, application process, and interviews.
Ophthalmology is a competitive specialty, although less so than it has been in the past.
In 2015, there were 808 applicants for 461 positions with an overall match rate of 61%
for all CAS participants (1). For those who submitted a rank list (and therefore attended
at least one interview), the overall match rate was 75%. The good news is U.S. medical
seniors have a match rate which is much higher than these figures (91%). Because of
the fierce competition, especially for placement into top programs, it is important to
begin preparing your application early. In fact, resume‐building should begin on your
first day of medical school. Create a document to keep track of every achievement and
volunteer activity you have completed during college and medical school (with dates).
This will make it much easier to create a CV when preparing your residency application.
A successful applicant will have a diverse and well‐rounded application. However, some
aspects are weighed more strongly than others by admission committees. Nallasamy
surveyed residency programs to analyze current trends in the residency selection
process. She determined the most significant factors by calculating the percentage of
programs rating various aspects as “very important” or “among the most important.”
The most significant factors were interview performance (95.4%), clinical course grades
(93.9%), recommendation letters (83.1%), and board scores (80.0%) (2). The least
significant factors were musical ability, having a parent as an ophthalmologist, being a
leader, being a high achiever in sports, and having a PhD.
3|PageFirst and Second Year
Preclinical Course Grades
It is important to study diligently for your basic science courses during your first and
second years of medical school and to earn as many Honors and Near Honors grades as
possible. While these grades are not weighted as strongly as your grades in clinical
rotations according to Nallasamy’s study, they will still appear on your transcript.
Furthermore, they are tremendously important in being elected into the Alpha Omega
Alpha (AOA) Medical Honor Society and mastering knowledge of the basic sciences will
prove useful when it comes time to take the USMLE Step 1 Board Exam the summer
between your second and third years of medical school.
Extracurricular Activities
Aside from grades, you should choose several extracurricular activities to pursue. These
may include student organizations, student government, tutoring, service projects, or
other activities. There are many volunteer opportunities available in the Iowa City area
and research positions are easy to acquire as a medical student. If you are a student at
Iowa, you should pursue one of the Research, Service, Humanities, Teaching, or Global
Health Distinction Tracks to gain official recognition for your activities. Finally, apply for
as many scholarships as possible as there is a rather large section on the application
specifically for awards. It is best to get involved with these activities early as time does
not become any more abundant during your third year.
USMLE Step 1 Board Exam
Before you may start your third year in the wards, you must take and pass the USMLE
Step 1 Board Exam. Your score on this exam is extraordinarily important when pursuing
a competitive specialty (3). Many programs use this score as a screen to determine
which applications to review, so if you score poorly the admission committee may never
see the rest of your stellar application. In her study, Nallasamy found that 78% of
programs used Step 1 scores as a factor in their selection process and 51% used the
scores to decide who to call for interviews (2). This practice was especially prominent in
more competitive programs and academic programs. For this reason, be prepared to
dedicate a significant amount of time and resources on this exam. The average Step 1
score continues to climb for both matched and unmatched applicants (Figure 1) (1). In
2015, those who matched averaged a score of 243 while those who did not match
averaged 228.
4|PageFigure 1. Average USMLE Step 1 Board Exam score for matched and unmatched applicants (1).
Third Year
Clinical Grades
Clerkship grades are more important than those on basic science courses as they are
more indicative of your real‐world performance in the hospital. Of all of your clerkships,
it is most important to achieve high marks in your ophthalmology rotations. Although it
is not essential, it may be useful to schedule your first ophthalmology rotation late in
the first semester of your third year. This allows you to become accustomed to the
hospital during other less‐crucial rotations, yet it is still early enough in the year to
confirm your interest in the field and pursue other ophthalmology‐related activities. It
is also a good idea to let your residents and faculty know that you are interested in
ophthalmology as they will pay extra attention to you during your time in the clinic and
it may even net you a better grade.
5|PageLetters of Recommendation
During your third year, be thinking about who you may want to ask for letters of
recommendation. It is helpful to have letters from well‐known faculty in the
ophthalmology department, but only if they know you well. Try to obtain your letters
from individuals you have worked with for at least a month, so the letter is meaningful
and personalized, and supply them with your curriculum vitae (CV) and transcript so
they have even more information on which to base the letter. You will need 3 letters for
your ophthalmology application with the option of adding another one to your
application for intern year. There are no strict guidelines regarding who to ask, but I
recommend obtaining 2 from ophthalmology faculty and 1 from faculty in another
department to diversify your application. You will need copies of your letters before
you are able to send your application materials to the SF match in early August. Do your
writers a favor and ask them for the letters at least a month or two before you need
them so they are not forced to write them on short notice. If you are planning on asking
someone with whom you worked early in your third year, it may be wise to let them
know after you finish working with them so they may make some memorable notes to
keep you fresh in his or her mind come letter‐writing time.
Though I did not personally experience this, I have heard that some prelim medicine
programs for intern year require letters from the chair of internal medicine at your
school or at least an internal medicine doctor. You may want to keep this in mind when
identifying people who may be well‐suited to write your letters.
If you attend Iowa you will receive a cover sheet complete with directions for your letter
writers. Check the box indicating that you waive the right to view your letters. This
assures programs that your writers are giving a complete, accurate, and uncensored
description of you. Despite checking this box, some writers may still send you a draft to
make sure it is accurate.
Curriculum Vitae
Begin preparing your curriculum vitae in late spring or early summer, prior to requesting
your letters of recommendation. In contrast to a resume, a CV is more focused on your
professional and academic activities. In other words, you do not need to mention the
summer you spent as a pizza delivery boy. Only include things that are relevant to your
residency application unless they are very distinctive activities or achievements that will
set you apart from the crowd. You will not actually send this CV with your application,
but it useful to organize your achievements and you can usually copy the information
directly over to your residency application later in the summer. Additionally, it is useful
if you provide your letter writers with a CV so they may learn more about you before
writing your letter of recommendation. The University of Iowa Carver College of
Medicine has an excellent website containing several example CV’s.
6|PageFaculty Meeting
It is wise to set up a meeting with a faculty member in the department during your third
year to express your interest in ophthalmology. This helps introduce you to the
department and he or she can assess your competitiveness for the specialty. It is helpful
if you can provide him or her with a CV and transcript to help with this process. If you
do this earlier in your third year, you should have time to buff out any potential
weaknesses in your application before you have to start preparing it for residency
programs.
Closer to interview season, you may want to set up a brief meeting with the department
head and residency director to introduce yourself. At Iowa, these people are Dr. Keith
Carter and Dr. Tom Oetting. Make sure you come prepared with specific discussion
points, questions, or material to review, otherwise you may find yourself in an awkward
silence – not a great first impression.
Eye Rounds
The University of Iowa Department of Ophthalmology maintains an excellent website
called Eye Rounds. The site contains a collection of interesting photos, videos, and cases
provided by residents, fellows, faculty, and students from the University of Iowa. The
site generates huge amounts of web traffic and the articles quickly shoot to the top of
the Google search results. This is a peer‐reviewed website and you can later list all of
your articles as publications on your application. You may write as many articles as you
wish and this is a great opportunity to meet faculty members in the department. I
would recommend writing at least one article during medical school. Eye Rounds is an
exclusive opportunity for students at Iowa as you must attend the university to submit
materials for the site. Contact Dr. Tom Oetting if you are interested.
Fourth Year
Electives
Most students choose to schedule an ophthalmology elective early in their fourth year
as this allows them to obtain a letter of recommendation from a faculty member before
they have to submit their application. To meet time constraints, this rotation must be
scheduled within the first 2 scheduling blocks of the year according to Iowa’s rotation
7|Pageschedule. While the second scheduling block can work in a pinch, it is not ideal as you
will have to ask for and receive your letter before even finishing the elective if you are
planning on submitting your application early in the timeline. At Iowa, there are
established clinical rotations in the cornea and neuro‐ophthalmology clinics. You may
also arrange personalized rotations in nearly any department if you contact the medical
education coordinator, Dr. Richard Olson.
Away Rotations
You may elect to arrange for an away rotation at another institution. Many students
choose to do this, although it is by no means mandatory. Away electives may help you
get a foot in the door, and can increase your likelihood of matching at the institution
where you are rotating. Bear in mind, the opposite can also be true. If you do not make
a good impression during the clerkship, you may actually hurt your chances. Doing an
away rotation does not guarantee you an interview spot at that institution and does not
affect your odds of matching at other institutions. It is also worth mentioning that most
other schools do not run on the same schedule as Iowa, so if you are an Iowa student
rotating elsewhere, you will likely have to use a week of vacation time both before and
after the rotation. If you are not planning on using the elective for a letter of
recommendation, you can save 1 week of vacation by scheduling your away as your final
elective before your time off for interview season.
USMLE Step 2 Board Exams
Students must take two more Board Exams during their fourth year. These include Step
2 Clinical Skills (CS) and Step 2 Clinical Knowledge (CK). The CS exam only requires a few
days of review as it is based around simulated patients. It is graded on a strictly pass‐fail
basis and may be scheduled any time before the New Year. Scheduling the CK exam is a
bit trickier and depends on how you did on Step 1. If you did well on Step 1, I would
advise not taking Step 2 CK until December to avoid jeopardizing your application.
Another good score will likely not help your application much, while a poor score could
lead to disaster! If taken in December, you will not receive your score until after the
match. On the other hand, if you were unhappy with your Step 1 score, an outstanding
Step 2 CK score can give your application a needed boost. In this scenario, it is in your
favor to schedule the exam early. There is a “sweet spot” in late fall where your score
comes back too late to be sent out with your application, yet you have it before
interviewing. You then have the choice of revealing your score to programs if you did
well, or concealing it if you did not do as well as you had hoped. Most people study at
least 1‐2 weeks for the CK exam.
8|PageAlpha Omega Alpha (AOA)
AOA Honor Society status is awarded in two waves – one in March of your third year
and one in late August of your fourth. Unless you were selected during your third year,
you will not know if you obtained AOA status prior to submitting your application if you
are sticking to the recommended timeline. On the CAS form, there is an AOA status
radio button to select “yes” or “no” – do not click either if you were not elected in your
third year as it is still uncertain whether you will be elected during your fourth. On your
main online profile (not within the CAS application), there is a section for your board
scores and AOA status. Here they include an “unknown” button which you may select.
You may not revise your CAS application after submitting it, but you can change this
main profile page to reflect AOA status updates. The timing of the AOA selection during
your fourth year works in your favor if you do not think you will make AOA as this will
not be shown on your application (“unknown” looks much better than “no”). AOA
status is not essential and most matched applicants are not AOA members, but it dose
significantly increase the odds of matching (Figure 2) (3).Error! Bookmark not defined.
Figure 2. Match results by Alpha Omega Alpha (AOA) Honor Society membership (3).
Time Off
While interviewing, I was amazed that many other schools allowed their students to skip
weeks of their rotations at a time for interviews without using vacation. If you attend
Iowa, you will want to schedule time off during interview season. The Carver College of
Medicine has a policy in which you are only guaranteed 1 day off per week during
November and December. Optimistically, you may have 10‐12 ophthalmology
interviews and another 5‐10 interviews for your intern year. Factor in social dinners and
9|Pagerealistic travel time, and it would be near impossible to meet the requirements of any
clerkship during interview season.
If you absolutely do not wish to schedule vacation for interviews, you may be able to
arrange for a more flexible rotation during this time, such as a research elective.
Research electives are difficult to secure during this timeframe as many students,
including those applying to other specialties, will be requesting them. Many other
students are going to want vacation time during this period as well, so it is important
that you rank it highly on your preference list. Use your #1 preference rank for your
early ophthalmology elective and your #2 rank for your vacation or research elective.
Don’t fret if a clerkship ends up being scheduled during your vacation despite your best
efforts. If this happens, contact Marcia Hopp and notify her of the problem. It is very
likely she will be able to help you rearrange your schedule before interview season rolls
around.
The Application Process
Residency Overview
Ophthalmology residencies are 3 years in length and require 1 year of general medical
internship before you may begin. A few programs, including Iowa, have an integrated
intern year which offers many advantages including additional ophthalmology training
compared to more traditional internships. At residency programs without an integrated
intern year, you may elect to do a preliminary year in internal medicine or general
surgery, or you may choose a transitional year in which you rotate through a variety of
different departments a few months at a time, similar to medical school. Transitional
years have a reputation of being less demanding of your time and they can be extremely
competitive for this reason. Not only do you compete with ophthalmology applicants
for these positions, but also with applicants from other competitive fields such as
dermatology, radiology, anesthesiology, and PM&R.
Many ophthalmologists decide to sub‐specialize after residency by means of a
fellowship. Fellowships in ophthalmology range in length from 1‐2 years. Options
include areas such as oculoplastics, retina, cornea and external disease, pediatrics,
neuro‐ophthalmology, glaucoma, and ocular pathology.
Acronyms
SF Match, CAS, ERAS, NRMP… The application process is wrought with acronyms. The
San Francisco Match (SF Match) is the program responsible for organizing and
10 | P a g eprocessing your ophthalmology application materials. The Central Application Service
(CAS) then distributes the actual application form to programs and eventually the SF
Match performs the algorithm which ultimately matches you with a residency program.
You apply for your intern year through the Electronic Residency Application Service
(ERAS), which is the same service your colleagues are using for their residency
applications to other fields. The National Residency Matching Program (NRMP) is the
organization responsible for matching you with a program for your intern year.
Electronic Application
The majority of your application is submitted electronically on the SF Match website.
You can start the electronic application on June 1st, and you may as well start it early as
you can save your progress. There are two main portions to the site, your SF Match
profile and the CAS application.
The SF Match profile is the page you initially see upon logging into the site. Among
other things, it includes your name, address, USMLE Step 1 score, AOA status, and
photo. Because your application timeline is ahead of your peers applying to other fields,
you may not yet have received a copy of your senior photo. This isn’t a problem, as
most programs do not view this photo prior to interviews. Including the photo is
actually optional and is really only used as a visual reminder of who is who when
programs are making their rank lists. If you are concerned, you can always take your
own photo at home. Unlike your CAS application, your profile page may be updated
after submission of your application as long as the SF Match hasn’t yet distributed your
information to programs.
The CAS application is the online equivalent of your CV. It was converted from a paper
form to a digital version in 2010 and has since undergone many changes. The website
contains text boxes for you to enter and format information any way you wish. Take
advantage of different formatting – bold, italics, and underlining to emphasize different
aspects of your application. If you prepared a CV, it will now come in handy as you can
essentially copy and paste the information into these text fields. When you are finished,
your application will be converted to a PDF document which is digitally distributed to
residency programs for review. While working on your application, you should check
the “preview” at the end of each section and the “final preview” at the end of your
application to see this final PDF version programs will be seeing. The system is still
under development and contains bugs. You may find that the formatting in the
generated PDF looks drastically different from what you entered. You may find bold
formatting, extra spaces, or even abrupt truncation of your information if it doesn’t fit in
the size constraints of the text box. This also applies to what you have copied and
pasted from Word, so check carefully.
11 | P a g eYou will spend many exhausting hours preparing your application, but keep in mind the
person reviewing your application will probably be skimming the entire thing in under a
minute. You want to make this person’s life easy. It is important to carefully organize
your information, include dates, and be concise. I would avoid full paragraphs for the
majority of your application, and instead use bulleted lists. You can copy and paste
bullets from Microsoft Word, use hyphens as bullets, or utilize a combination of both for
multileveled lists. The only section that warrants a full paragraph, in my opinion, is the
“career objectives” section. Here you should describe whether you are most interested
in academia or private practice, how you will balance research and clinical practice, and
whether you are interested in any particular fellowships. As mentioned elsewhere in
this guide, it is best to lean toward academics and maintain ties to research for
application and interview purposes, as this will increase your likelihood of receiving
interviews at the more academic (and generally more esteemed) institutions.
Personal Statement
Similar to applying for medical school, you will need to write a personal statement. This
should be a single page capturing your unique background with the path that led you to
ophthalmology. Use the opportunity to grab the attention of the person reading your
application, but do not go too far with your creativity. I recommend writing your
personal statement like a novel, giving a brief overview of your life and the events that
led to your interest in ophthalmology. Be descriptive and try to paint a picture in the
reader’s mind. Provide just enough information about interesting events and
experiences to pique the reader’s interest, but intentionally leave out detail so they are
salivating for more. This will create a desire to interview you so they may ask further
questions, and create easy discussion points during your interview day. Give them
examples that demonstrate important qualities in the profession such as intelligence,
fine motor skills, and the ability to communicate with others. Let them connect the dots
without explicitly mentioning how these activities relate to the field, then bring
everything together in a grand conclusion paragraph. Revise, revise, revise. When you
think you are done, put your statement down for a week, then revise it again. The
personal statement is a very important piece of your application package and you want
it to leave a lasting impression. The Carver College of Medicine has advice and examples
at their website.
I have heard admissions committee members joke about some of the ridiculous
personal statements they have read. Sounding crazy in your personal statement (“the
eye is the window to the soul…”) may quickly land your application in the waste basket.
Do not talk about how your rare eye disease got you interested in ophthalmology
because admitting such a disability can greatly handicap you in a very visual specialty
and may cause programs to hesitate when considering your application. Be very careful
about how you word each sentence and the conclusion to which a critical reader may
jump. Those reviewing your personal statement will be carefully searching for any clue
12 | P a g ethat may give them a reason not to invite you to interview. Finally, and most
importantly, do not misspell the word o‐p‐h‐t‐h‐a‐l‐m‐o‐l‐o‐g‐y!
You must also submit a personal statement with your ERAS application for intern year.
How you approach this is entirely up to you. Some applicants resubmit their exact
ophthalmology statement while others write a completely new one. Most applicants,
however, strike a happy medium by reusing the bulk of their ophthalmology statement
while tweaking a few sentences in the conclusion paragraph to state how an intern year
will make them a more rounded physician. Prelim and transitional year admissions
committees realize you are ultimately going into ophthalmology and are more
interested in what led you to choosing that specialty rather than why you are dying to
be an intern for a year.
Program List
The final component of the online application is a list of all programs to which you
would like your application to be submitted. Choosing programs can be tricky and is
discussed later in this guide. You are billed for each program you include, and this price
rises incrementally as you apply to more programs (see table below). If you are
submitting a well‐pruned list, it is in your best interest to determine your definitive list
prior to submitting your application, as later add‐ons come at an inflated price of $35
per program regardless of how many programs were selected in the initial distribution.
If you are initially applying to over 40 programs, you will be paying $35 each at that
point anyway, so there is no increase in price for later add‐ons.
# of CAS Distributions Fees
1 – 10 $60 total
11 – 20 $10 per program
21 – 30 $15 per program
31 – 40 $20 per program
41 or more $35 per program
Supporting (Mail Submission) Materials
Being the 21st century, you would think the SF Match would have a fully electronic
submission. However, they still require you to physically mail your supporting materials
(transcripts, letters of recommendation, USMLE scores, etc.) so they can scan and
distribute them to programs. Each of these components is covered below.
13 | P a g eLetters of recommendation
Hopefully by this point, you have found suitable writers for your letters of
recommendation and already asked them if they would be willing to write for you. At
Iowa, the letters will be sent to the OSAC office where they will be scanned and sealed
in envelopes with signatures over the envelope flap. You will eventually pick up the
sealed envelopes to mail them to the SF Match with the rest of your application
package.
Transcripts
The SF Match requires applicants to obtain and submit transcripts for all undergraduate,
graduate, and medical schools they have attended. ERAS, however, does not require an
undergrad transcript, so you will only need to request one copy from your undergrad
institution. When you receive your transcripts, leave them sealed in the envelopes in
which you received them. If you took any classes at another college, include these as
well if they are related to your science or pre‐medical degree. If not, they are not
required (for example, I did not request a transcript for my outside SCUBA certification
course for which I received college credit).
At Iowa, your medical school transcript can typically be ordered through ISIS after
August 1, but sometimes a bit earlier. Ask Annette Griffin if you are unsure. If you also
did your undergrad at Iowa, your undergrad coursework will appear on the medical
school transcript so you do not have to order a separate copy.
Transcript requests can sometimes take a few weeks to process and receive through the
mail, so do not put this off until the last second.
USMLE Board Scores
You must also include a copy of all USMLE scores you have received thus far. They tell
you to order an official score report which costs a whopping $70. Not so fast! Put your
wallet back in your pocket and print out the free student print‐out, including the score
breakdown, by logging in to the USMLE website. This is the same PDF report you
checked to discover your score(s) for the first time. I previously verified this with SF
Match and this score report is sufficient for your application.
Additionally, USMLE Board scores are released to the SF Match program electronically
when you give them permission on their website. They give you the option of
automatically updating your application whenever a new score becomes available, but it
is in your best interest to decline. If you do receive your Step 2 score during the
application process, you then have the option of releasing it to programs if you scored
well, while retaining it if you didn’t.
14 | P a g eAOA Induction Letter
Finally, include your AOA induction letter if you have received one.
Additional Materials
Some schools will require you to send additional materials with your application for it to
be considered. These include things such as CV’s, an additional statement specifically
stating why you are interested in their program, or a clinic note from a recent eye exam.
This information is usually on the SF Match website, but occasionally it is not. I would
spend a few minutes perusing the website for each program to which you are applying
to make sure you are not closing any doors just because you forgot to send a supporting
document.
Submission
Many of these components will be sealed in their own envelope to prevent tampering.
You may wish to label the bottom corner of each envelope with its contents to keep
everything straight. Put all of these in a single, larger envelope along with a sheet of
paper stating your name and application number to make things easier on the person
opening your envelope in San Francisco. FedEx and UPS offer real‐time package
tracking, but are expensive (at the time of my application, FedEx was charging $27 for 2‐
day delivery). USPS Priority Mail is a more budget‐friendly option (it was about $6 for 2‐
3 day delivery). Each year a “target date” in late August or early September is provided
on a timetable posted on the SF match website. This is the date by which you want
them to have distributed your complete application package to programs to avoid
missing deadlines at most programs (not the date by which you should have mailed your
supporting materials). Keep in mind, it takes up to 3 weeks for your application package
to reach them by snail mail and for them to scan and process your documents before
they are ready for distribution. Programs individually set deadlines, and some are as
early as September 1, so make sure to find the dates for the programs to which you are
applying. Additionally, applications are eventually sent out in waves and it is in your
advantage to be in the first wave, so the earlier the better. Shoot for early to mid
August, at least 3 weeks prior to the posted target date.
Dean’s Letter
The Dean’s Letter is a generic summary of your academic achievements and
extracurricular involvement. It includes the comments you have received on your
evaluation forms during your second and third year as well as your performance in each
class as compared to your peers. The letter is compiled and automatically sent to SF
Match and ERAS after it is released on October 1. In my experience, this letter was
probably the most overlooked piece of information by ophthalmology admissions
committees and was admittedly of very low importance.
15 | P a g eChoosing Ophthalmology Programs
Selecting the programs to which you should send your application can be a daunting
task. There are currently between 110 and 120 ophthalmology residency programs in
the country (search FREIDA for a complete list). If you can specify your search to a
specific geographic region, that will narrow the options considerably. However, this
may not be possible as the best programs are sprinkled across the country. There are a
variety of websites providing information on programs, but you must take this with a
grain of salt because there is no way to be certain who is writing the reviews. Some of
these sites include the Residency Compendium thread at Student Doctor Network
(which is moderated by Dr. Doan who completed his residency at Iowa), Scutwork, and
MatchApplicants among others. You can also use Google to find departmental websites
and these are usually fairly helpful. The Ophthalmology Times previously ranked
departments annually and they also specifically provided rankings for residency
programs. They no longer perform these rankings, but the most recent results from
2010 are displayed below (Table 1) (4). These may not be entirely accurate anymore as
some of these programs have undergone significant changes such as that acquisition of
the Doheny Eye Institute by UCLA.
U.S. News & World Report continues to rate ophthalmology clinics annually, but does
not specifically rank residency programs (Table 2). Nobody knows exactly how reliable
these rankings are, and while the exact order is often debated, any program appearing
in the “top 10” is generally highly regarded. They are now integrating physician votes
from the physician social media website Doximity.com into their rankings. Hopefully
they will find a way to maintain some degree of objectivity in the rankings rather than
turning them into a popularity contest.
16 | P a g eBest Overall Best Research Best Residency Best Clinical
Programs Programs Programs (Patient Care)
Programs
1. Bascom Palmer Eye 1. Wilmer Eye 1. Bascom Palmer Eye 1. Bascom Palmer Eye
Institute/University of Institute/Johns Institute/University of Institute/University of
Miami Hopkins University Miami Miami
2. Wilmer Eye 2. Bascom Palmer Eye 2. Wilmer Eye 2. Wilmer Eye
Institute/Johns Institute/University of Institute/Johns Hopkins Institute/Johns
Hopkins University Miami University Hopkins University
3. Wills Eye 3. Massachusetts Eye 3. Wills Eye 3. Wills Eye
Institute/Thomas and Ear Institute/Thomas Institute/Thomas
Jefferson University Infirmary/Harvard Jefferson University Jefferson University
4. Jules Stein Eye University 4. University of Iowa 4. Jules Stein Eye
Institute/UCLA 4. Jules Stein Eye 5. Jules Stein Eye Institute/UCLA
5. Massachusetts Eye Institute/UCLA Institute/UCLA 5. University of Iowa
and Ear 5. Duke University Eye 6. Duke University Eye 6. Duke University Eye
Infirmary/Harvard Center Center Center
University 6. University of Iowa 7. Massachusetts Eye and 7. Massachusetts Eye
6. Duke University Eye 7. Wills Eye Ear Infirmary/Harvard and Ear
Center Institute/Thomas University Infirmary/Harvard
7. University of Iowa Jefferson University 8. Doheny Eye University
8. Doheny Eye 8. Doheny Eye Institute/University of 8. W.K. Kellogg Eye
Institute/University of Institute/University of South California Center/University of
South California South California 9. Emory Eye Michigan
9. Washington 9. Washington University Center/Emory 9. Doheny Eye
University in St. Louis in St. Louis University Institute/University of
10. W.K. Kellogg Eye 10. Scheie Eye 10. W.K. Kellogg Eye South California
Center/University of Institute/University of Center/University of 10. Emory Eye
Michigan Pennsylvania Michigan Center/Emory
University
Table 1. Ophthalmology Times ophthalmology program rankings, 2010 (4).
2015 U.S. News & World Report Ophthalmology Rankings
1. Bascom Palmer Eye Institute/University of Miami
2. Wills Eye Institute/Thomas Jefferson University
3. Wilmer Eye Institute/Johns Hopkins University
4. Massachusetts Eye and Ear Infirmary/Harvard University
5. Stein and Doheny Eye Institutes/UCLA
6. Cleveland Clinic
7. University of Iowa
8. Duke University Eye Center
9. USC Eye Institute
10. W.K. Kellogg Eye Center/University of Michigan
11. New York Eye and Ear Infirmary
12. Emory Eye Center/Emory University
13. Barnes‐Jewish Hospital/Washington University
Table 2. U.S. News & World Report ophthalmology program rankings, 2015 (5).
17 | P a g eYou can mine out a fair amount of information on your own, but the best resources, by
far, are faculty members, residents, and fellows in the department. Ophthalmology is a
relatively small field and there is a good chance these people have colleagues and
friends at other institutions. This provides wonderful insight that rankings will not
specify, such as whether the atmosphere is “malignant,” if residents seem happy, and
how prepared residents are after graduation. They may also know of upcoming changes
to a program that may not otherwise be advertised during the interview process. Ask
your mentor(s) if you can meet to discuss your application and suitable programs for the
strength of your application. At Iowa, Dr. Tom Oetting and Dr. Richard Olson are always
happy to meet with students for this purpose.
There is good reason to meet with a knowledgeable person who is able to match your
application strength with the programs to which you should apply. The residency match
works differently than applying to college where you could apply to safety schools and
know you would be accepted. Residency programs take pride in matching applicants at
the top of their rank lists. If you are a super‐applicant, a lower‐tier residency program
may not rank you highly or even interview you because they know you are not going to
end up at their program. They often prefer to use their top ranking positions on
applicants whom they think will end up at their program so they match higher on their
list. It sounds silly, but it’s the way the match system works. To summarize, applying to
lower‐tier schools with a competitive application may not net you many interviews in
the same way that applying to competitive schools with a weak application won’t. You
want to diversify between program strength to a certain extent, but your program list
needs to be matched to your application strength.
Another consideration is whether you intend to go into private practice or academics.
Some programs are more well‐known for research and producing academic physicians
while others are more tailored toward training comprehensive ophthalmologists going
into private practice. There is a section of your application asking what your aspirations
are as a future physician. Putting academics in this section should not limit your
interview offers, but putting private practice may turn off some of the more academic
programs. For this reason, I would recommend leaning toward academics for interview
purposes.
There is no set number of programs that is right for everyone and the majority of
applicants end up applying to many more than they should. In 2015, the average
applicant applied to 61 programs, a number that continues to rise each year (Figure 3)
(1). SF Match charges an incremental application fee depending on how many programs
you wish to apply and this is a good reason to limit your number. Depending on your
competitiveness, the sweet spot as a compromise between cost and safety is in the 30’s.
Beyond 40, the fee increases to $35 per additional program. If your application is less
competitive, however, it is a worthwhile investment to apply to many programs to
increase your odds of receiving a sufficient number of interview offers.
18 | P a g eFigure 3. Average number of ophthalmology residency applications submitted per applicant (1).
Choosing Programs for Intern Year
A few ophthalmology programs in the country, including the University of Iowa, now
have integrated intern years. This is a tremendous advantage in a variety of ways. If
you schedule your internship interviews after Ophthalmology Match Day, you can save a
huge amount of time and money by canceling all of these interviews if you happen to
match at one of these programs. You can also potentially eliminate one move (which
can cost thousands of dollars) since you’ll be at the same location for both components
of your residency training. In terms of education, you will have an entire year to
familiarize yourself with the location, hospital systems, and electronic medical record,
prior to starting residency. Meeting individuals in other departments is useful as you
will be interacting with these people during consultations as an ophthalmology resident
during your next 3 years. Finally, and most importantly, you will receive additional
ophthalmology training during your intern year which you would not otherwise receive
in the more traditional internships. At the University of Iowa, interns receive 5 months
of ophthalmology training during their internship prior to beginning residency and
taking their first day of ophthalmology call. This is invaluable.
If you match at one of the majority of programs that still does not have an integrated
internship, you have the choice of completing a transitional year, a prelim year in
internal medicine, or a prelim year in general surgery. In general, transitional years are
more desirable as they offer a more diverse experience and require less work hours.
That being said, transitional years can be extremely competitive and are not available at
all institutions.
19 | P a g ePeople have varying opinions on where to do their intern year. Some view it as an
opportunity to travel to an exotic destination for a year before returning for their
ophthalmology residency. Others want to minimize the number of times they are
required to move and they look in either the city of their medical school or the city of
their future residency program. Unlike other applicants for transitional and prelim
years, as an ophthalmology applicant you will have the advantage of knowing where you
matched for residency before having to submit your rank list due to the early match.
It can be much more difficult to find information on transitional and prelim programs
than their ophthalmology counterparts. The best source for information on these
programs is by word of mouth. Talk with M4’s who have finished interviewing or
current residents in fields requiring a separate intern year. Past program reviews can be
found on various message boards across the internet, but with the change in intern
duty‐hours requirements in 2011, all programs have had to redesign the way their
residents take night float and call. Until newer reviews are posted, it will be difficult to
know which programs are now “cush” and which have forsaken their coveted “cush”
reputation.
The optimum number of applications for intern year varies widely depending on who
you ask. I’ve talked to residents who only applied to 1 and others who applied to 30. I
think anywhere from 10‐15 is generally appropriate.
Interviews
You have submitted your application and are now waiting for interviews – what a relief!
There is still plenty of work to do as interview season is just around the corner. Most
interviews take place between late October and mid December. Hopefully you have
scheduled vacation during this time as most clerkships are not very forgiving for missing
more than 1 day per week.
Master Calendar
Interview offers are generally sent out by email, although a few are made by phone.
Programs have limited dates available and they fill up ridiculously fast. This means you
need to be on your toes, ready to respond to any interview emails within minutes to get
your first choice of dates. For this to work efficiently, I recommend making a calendar
to determine your optimal interview schedule. I used Google Calendar and printed a
paper copy to carry in my pocket, but anything will do as long as it is easily accessible
and always with you. Using a combination of SF Match (click on the program names)
20 | P a g eand departmental websites, find this year’s interview dates for all of the programs to
which you are applying. If you cannot find the dates for a program in which you are very
interested, you can politely send the program coordinator an email asking if the dates
have been decided. Put all of the dates on your calendar then find a combination that
allows you to visit all of your top choices. It may be helpful to group them by geographic
location, but this is not always possible. Also keep in mind that many programs have an
interview dinner the night before or after your interview, so try not to pack your
interviews too tightly. Programs typically notify you of dinner times alongside their
interview offer or in your scheduling confirmation email – do not forget to add these
additional commitments to your master calendar as you will need to adjust your travel
and schedule accordingly. With this calendar, you will be able to instantly respond to
invitation emails with your date selection without giving it a second thought.
There is some debate over scheduling early versus later in the season. The thought is
that those who make a positive impression early will be held in high esteem and the
later applicants may not live up to these high standards the interview committee has
built up. Interviewing early has the possible downside that you will be forgotten later in
the season and lost among the sea of later applicants. Later interviewers are more
recent in the committee’s mind when forming the final rank list. I personally liked
scheduling the later interview dates for the programs I was most interested in, but in
the end, the difference is probably not too significant. If you do have an earlier
interview date with a program, you may elect to send them an email around the time of
their final interviews to re‐iterate your interest in the program and bring your name
back into the spotlight.
Another consideration in making your schedule is interview performance. Most
interviews end up being fairly similar so you become more skilled at interviewing as the
season progresses. Late in the season, however, you may begin to fatigue and your
performance may actually decline as a result. Therefore, peak performance usually
takes place midway through the interview season.
Despite all your hard efforts, you are bound to end up with some interview dates you
didn’t anticipate. You can contact programs with whom you previously had scheduled
interviews and ask if they have openings on other dates for you to swap. If not, they can
often put you on a waiting list and contact you when one becomes available.
Additionally, I’ve heard of others having success using the annual “interview swap
thread” on Student Doctor Network where applicants work out personal trades with
each other and simply contact the program to inform them of the change.
Smartphones
As I mentioned, the desirable dates fill up obscenely quickly. To get your optimal
schedule, you literally need to respond within minutes for most programs. Obviously,
21 | P a g eyou are not going to be sitting in front of a computer all day, so your smartphone will
become your best friend. If you don’t have one, now may be the time to consider the
upgrade. Enable email alerts so you are instantly notified when you have received a
new email. If you receive many unrelated emails throughout the day, your phone will
become the boy who cried wolf. One option to remedy this situation is to create a
unique email address exclusively for the SF Match website and other interview‐related
activity. Remove all other email accounts from your phone so you know that every
email alert concerns an interview. This will give you an advantage in the battle against
time. If you do receive an interview offer during the day, politely excuse yourself from
whatever you are doing and send a quick response on your phone. Do not put off your
reply, or the most coveted dates will fill. To respond speedily to emails, I had a saved
draft of a reply that I could fill out quickly with my date preferences. It thanked the
coordinator for the invitation, followed by “My first choice of interview date is ____,
followed by ____ as my second choice, and ____ as my third.” If multiple dates
potentially worked in my schedule, I listed them in order of preference. If I could only
attend a single date, I would request it and elect for the waiting list if I was too sluggish
in my response to snatch it up.
For those Iowa students who refuse to purchase a smartphone, it is possible to forward
university emails containing certain keywords (i.e., “interview,” “ophthalmology,” and
“residency”) to your pager’s email routing address using Outlook rules (options > create
an inbox rule > new). If you elect to do this, do not use “eye” as a keyword or you will
get excited about every “Hawkeye” email that you receive. To forward emails to your
pager, route them to ####.uihc@paging.healthcare.uiowa.edu (where #### is your
pager number). Beware, forwarding email to your pager will forward the entire email
separated into chunks abiding to the allowed character limit – be prepared to receive a
rapid fire succession of pages for each email. Even if you do have a smartphone, this is
still helpful as your pager gives you an excuse to step out of lecture or clinic to send a
quick reply.
Interview Number
In 2015, the average applicant received 4.3 interviews (1). Early on, you should accept
every interview offer you receive to build your numbers. If you are fortunate, you may
eventually have more interviews than you need and you will have to decide how many
to keep. The more interviews you attend, the more programs you can order on your
rank list. One would think more interviews would therefore increase your chances of
matching and this is true to some extent. This was investigated by Yousuf, and in 2011,
he found a clear benefit up to 6 programs (3). After this, however, returns began to
diminish. After the 11th program, there was no longer any additional significant benefit.
Therefore, I would shoot for 10‐12 interviews if you can get them. If you decide to
cancel an interview, let the program know as soon as possible so they may offer the
position to a more interested applicant. There is absolutely no reason to keep them on
22 | P a g eYou can also read
